over-the-counter

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1、ParticipantID____________________DateCompleted__________________InterviewerInitials_______________Beginning/EndTime___________/__________Women’sHealthStudy3MonthPostExamInterview****movedthegeneralhealthquestionsupintheorder,addedquestionsonhealthsystemTableofContentsPageNum

2、berA.IntroductionandInformedConsent23B.OverviewofInterviewC.CurrentSymptomsI.CurrentPainSymptoms[q.1-9]4II.CurrentSomaticSymptoms[PILL;q.10-64]5III.DepressiveandAnxietySymptoms[DASS;q.72-92]11IV.PostTraumaticStress[PSS-I;q.93-109]13V.GeneralHealthandMissedWork/Activities[SF1

3、2;q.65-71]7VI.MissedWorkandActivities[q.110-111]15D.CurrentMedicationsandHealthUtilizationI.MedicationUse[q.112-113]16II.TreatmentandHealthCareUtilization[q.114-119]17E.CURRENTSOCIALSUPPORTANDCOPINGI.SocialSupport[SRQ;q.120-140]20II.PostTraumaticGrowth[PTGI;q.141-161]22ADDED

4、POLICEQUESTIONSHEREF.Demographics[q.162-166]REMOVED24G.ParticipantFeedback[q.167-178]27H.RequestforAdditionalInterview[q.179-190]29I.Closing33J.InterviewerFeedback[q.191]34K.AppendixII.InformedConsentII.AnswerCardsIII.ReleaseofInformationLetterIV.CommunityResourceGuide[Ingha

5、mClintonandEatonCounty]V.Women’sHealthStudyinformationVI.Paymentandreceiptofpaymentform43ParticipantID____________________DateCompleted__________________InterviewerInitials_______________Beginning/EndTime___________/__________43ParticipantID____________________DateCompleted_

6、_________________InterviewerInitials_______________Beginning/EndTime___________/__________Women’sHealthStudy3MonthPostExamInterviewA.INTRODUCTIONThankyouformakingtimetoseemetoday.Asyouweretoldwhenyouscheduledthismeeting,thisisthethirdinterviewandwilltakelessthananhourtocompl

7、ete.Youwillbepaid$70.00foryourtimetoday.Thereasonwearedoingtheseinterviewsisbecausewewanttobetterunderstandhowwomenrecoverovertimeaftersexualassault.Iappreciateyourwillingnesstotalktometodayaboutyourexperiences.Theinformationyouprovidewillbeextremelyhelpful.BeforewebeginIwan

8、tedtoaskifitwouldbeOKformetotaperecordthisinterview.It’sgoingtobehardtogete